炎症因子与胰岛素抵抗及糖尿病亚临床血管病变的关系研究  

The Correlations between Inflammatory Factors,Insulin Resistance and Diabetic Sub-clinical Vascular Disease

作　　者：蒋晓真[1] 邹宇峰[1] 顾哲[1] 江泉[1] 顾佩莉[1] 朱震宏[1] 徐凌燕[1] 

机构地区：[1]浦东新区人民医院内分泌科,上海市201200

出　　处：《中国全科医学》2010年第26期2900-2902,2905,共4页Chinese General Practice

摘　　要：目的探讨血清脂联素、瘦素、肿瘤坏死因子-α(TNF-α)与2型糖尿病(T2DM)患者胰岛素抵抗及亚临床血管病变的相关性。方法选择199例T2DM患者,根据颈动脉内膜中层厚度(IMT)将患者分为两组:IMT≥0.9mm者作为亚临床血管病变组(A组,110例),IMT<0.9mm者作为无血管病变组(B组,89例)。检测两组患者血清脂联素、瘦素、TNF-α水平,计算胰岛素抵抗指数(HOMA-IR)。分析脂联素、瘦素及TNF-α与HO-MA-IR、IMT的关系。结果 A组患者血清脂联素水平〔(2.76±1.25)mmol/L〕显著低于B组〔(3.06±1.40)mmol/L〕,而瘦素水平〔(0.85±0.44)mmol/L〕显著高于B组〔(0.62±0.36)mmol/L〕,差异有统计学意义(P<0.05);而TNF-α水平〔分别为(0.44±0.13)pg/ml和(0.38±0.12)pg/ml〕间差异无统计学意义(P>0.05)。脂联素与HOMA-IR、IMT呈负相关(P<0.05),瘦素与HOMA-IR、IMT呈正相关(P<0.05),TNF-α仅与IMT呈正相关(P<0.05)。结论脂联素可能是T2DM患者胰岛素抵抗及亚临床血管病变的保护因子,瘦素可能是二者的危险因子,而TNF-α与胰岛素抵抗无明显相关性。Objective To explore the correlations between serum adiponectin （APN）,leptin （LEP）,tumor necrosis factor-α （TNF-α）,insulin resistance and sub-clinical vascular disease in type 2 diabetic patients.Methods 199 patients with type 2 diabetes mellitus were selected,they are divided into two groups according to the carotid intima-media thickness （IMT）：sub-clinical vascular disease group,which includes patients whose IMT≥0.9 mm （A group,110 examples）,the other was non-clinical vascular disease group,which includes patients whose IMT0.9 mm （B group,89 examples）.Test the levels of APN,LEP and TNF-α,calculate the insulin resistance index （HOMA-IR）,and analyze the correlations between APN,LEP,TNF-α,HOMA-IR and IMT.Results The level of APN in group A〔（2.76±1.25）mmol/L〕 was significantly lower than that in group B〔（3.06±1.40）mmol/L〕,while the level of LEP in group A〔（0.85±0.44）mmol/L〕 was significantly higher than that group B〔（0.62±0.36）mmol/L〕,there were significant differences between the two groups （P0.05）.But there was no significant differences between the level of TNF-αin group A〔（0.44±0.13）pg/ml〕 and group B〔（0.38±0.12）pg/ml〕（P0.05）.APN was negatively correlated to HOMA-IR and IMT （P0.05）,LEP was positively correlated to HOMA-IR and IMT （P0.05）,but TNF-α was only positively correlated to IMT（P0.05）.Conclusion APN may be the protective factor of insulin resistance and sub-clinical vascular disease in T2CM patients,while LEP may be the risk factor,but TNF-α was not significantly related to insulin resistance.

关 键 词：脂联素 瘦素 肿瘤坏死因子Α 胰岛素抵抗 亚临床血管病变 

分 类 号：R587.1[医药卫生—内分泌]